Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Perils of a postpartum pediatrician

Lisa Sieczkowski, MD
Physician
September 17, 2018
Share
Tweet
Share

During my first pregnancy, I frequently dreamt of my baby. I couldn’t remember the details of facial features or hair color, but I always knew that I was going to have a girl.

Three years passed after Claire was born, two more heartbeats were identified and then lost somewhere deep within my abdomen. On two occasions, I watched blood seep from my body and stain my clothing, realizing that I didn’t know if it was my blood or my baby’s. I watched our blood ripple into concentric circles as it dripped into the toilet.

I clung to the fact that I had a healthy beautiful toddler. I rocked her to sleep each night and sang to her long past the time when her body grew slack in my arms, and her breathing became slow and regular. “So sleep tight baby, unfurrow your brow and know I love you. We’re alright for now, we’re alright for now.”

Months went by with their clockwork crimson verification that I was still not pregnant. Bloodwork obtained after the second miscarriage revealed a clotting disorder of questionable significance. I was straddling the fertility precipice of my 35th birthday. I second-guessed my decision to pursue a career in medicine, delaying marriage until age 29. I cursed the slow wheels of evolution, irritated that our bodies are still prime to reproduce in our teens and 20s even though emotionally and financially we are better off in our 30s and 40s.

After nearly a year, I discovered that I was pregnant in the Target bathroom. I saw a high-risk OB/Gyn and was labeled an elderly multigravida. I injected anticoagulants into the soft flesh of my belly twice a day, just to be safe. I delivered a perfect baby boy at 38 weeks.

Charlie was perfect until the evening when I noticed that he had the mildest of retractions, causing his chest to suck in right below his ribcage with every breath. I snuck a stethoscope out of my bag and listened to Charlie’s heartbeat. It was way too fast for a sleeping infant. I repeatedly calculated the horrifying sum of 200 beats per minute.

I packed a bag to take to the ED, certain that we would be admitted to the PICU with a life-threatening congenital heart defect. I was already envisioning Charlie’s inevitable first open-heart surgery.

But when we got to the ED, the triage nurse looked at my seemingly healthy baby and seemed perplexed. I had to sheepishly explain that I had broken a cardinal rule of physician parenthood — listening to one’s own child’s heart. But my embarrassment was no match for my terrified conviction. She counted his pulse for 10, maybe 20 measly seconds. “It’s normal,” she chirped.

Once in the exam room, I was dismayed to see one of the newest ED attendings making his way toward us. He glibly stated/inquired, “I know that part of my job is to reassure you, so what can I do to make you feel better?”

“Well, can you at least put him on a monitor?” I asked, incredulous that this had not yet been done. Charlie was attached to the cardiorespiratory monitor that confirmed that his heart rate was trucking along at 215. Dangerously close to being textbook SVT. While we sat there, my eyes glued to the monitor, Charlie fussed a little and I started to nurse him. ED Physician was quick to point out that eating was exercise for babies, so of course his heart rate would be high!

After he left again, I watched as the number on the monitor gradually went down to the 170s over the next 30 minutes. When he returned, I curtly stated, “I’m reassured that he does not have anything immediately life-threatening,” so we were given our discharge papers. Over the next couple of days, Charlie’s heart rhythm, structure, and function were carefully evaluated and pronounced normal.

Within days, though, I felt Charlie’s foot twitch rhythmically while I held his ankles during a diaper change. I quickly tried to reproduce the twitching by bending his foot back at the ankle, a maneuver to check for clonus. Sure enough, I could get his tiny feet to twitch five, ten —, sometimes even 15 — times in a row. Clonus is a pathologic neurologic finding in older humans, but I was desperate for reassurance that it could be normal in infants.

So I broke another fundamental rule, fully aware of the Pandora’s box I was opening, by performing a Google search. Not even a medically sophisticated one. I found an article that correlated the number of clonus beats with abnormal neurologic outcomes. I was devastated by this article and its implication that my son had a high likelihood of pathology. I spent weeks of my maternity leave obsessively checking him for clonus hundreds of times per day.

ADVERTISEMENT

I slept on the living room couch next to his bassinet. Every time he stirred, the noise from the plastic mattress cover woke me up. I was analyzing Charlie’s every move, certain that his jerky baby movements portended an ultimate diagnosis that would break my heart. I poured out my observations to my husband who tried to reassure me that we would love Charlie no matter what. I called my mom and begged her to pray for Charlie and me. I stood sobbing on the front porch, repeating my pleas over and over because she couldn’t understand my anguished, distorted words.

I held Charlie for hours that winter as we watched the Oscar contenders. Toward the end of my maternity leave, I mustered enough insight to call my obstetrician, to meet with a counselor and to start a lactation-friendly SSRI. I know I love Charlie, and we’re alright for now. But I wish I could have fully immersed myself in those heady hours and days of his fleeting infancy. I worry about how my worry may have impacted him, that tiny vulnerable creature who bore the brunt of my scrutiny.

Lisa Sieczkowski is a pediatrician. 

Image credit: Shutterstock.com

Prev

A resident physician's story of depression

September 17, 2018 Kevin 0
…
Next

Burnout doesn’t start in medical school

September 17, 2018 Kevin 1
…

Tagged as: OB/GYN, Pediatrics

Post navigation

< Previous Post
A resident physician's story of depression
Next Post >
Burnout doesn’t start in medical school

ADVERTISEMENT

More by Lisa Sieczkowski, MD

  • Residency programs value diversity and inclusivity

    Lisa Sieczkowski, MD
  • How the pandemic affects the residency match

    Lisa Sieczkowski, MD
  • COVID and schools: Our only certainty is uncertainty

    Lisa Sieczkowski, MD

Related Posts

  • Medicaid expansion for postpartum support

    Kimi Chernoby, MD, JD and Claire Dowell
  • A physician’s addiction to social media

    Amanda Xi, MD
  • The basics of the MMR vaccine from a pediatrician

    Roy Benaroch, MD
  • A pediatrician was bullied by his fellow physicians on Twitter

    Mick Connors, MD
  • A #MeToo moment with a pediatrician

    Lauren Feltz, MHSc
  • Using probiotics in children: a pediatrician’s take

    Christopher Johnson, MD

More in Physician

  • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

    Yousuf Zafar, MD
  • The hidden rewards of a primary care career

    Jerina Gani, MD, MPH
  • Why doctors regret specialty choices in their 30s

    Jeremiah J. Whittington, MD
  • 10 hard truths about practicing medicine they don’t teach in school

    Steven Goldsmith, MD
  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
    • A surgeon’s testimony, probation, and resignation from a professional society

      Stephen M. Cohen, MD, MBA | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance
    • Why doctors regret specialty choices in their 30s

      Jeremiah J. Whittington, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Perils of a postpartum pediatrician
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...